Provider Demographics
NPI:1831913508
Name:PRECIOUS LIFE CARE LLC
Entity type:Organization
Organization Name:PRECIOUS LIFE CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:MAYSOON
Authorized Official - Middle Name:
Authorized Official - Last Name:DENG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-544-9239
Mailing Address - Street 1:3915 BISON TRL
Mailing Address - Street 2:
Mailing Address - City:WAUKEE
Mailing Address - State:IA
Mailing Address - Zip Code:50263-1206
Mailing Address - Country:US
Mailing Address - Phone:602-544-9239
Mailing Address - Fax:
Practice Address - Street 1:3915 BISON TRL
Practice Address - Street 2:
Practice Address - City:WAUKEE
Practice Address - State:IA
Practice Address - Zip Code:50263-1206
Practice Address - Country:US
Practice Address - Phone:602-544-9239
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-11
Last Update Date:2024-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No253Z00000XAgenciesIn Home Supportive Care